Search

The fraction of organic matter present affects the fragmentation behavior of sialoliths; thus, pretherapeutic information on the degree of mineralization is relevant for a correct selection of lithotripsy procedures. This work proposes a methodology for in vivo characterization of salivary calculi in the pretherapeutic context. Sialoliths were characterized in detail by X-ray computed microtomography (μCT) in combination with atomic emission spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. Correlative analysis of the same specimens was performed by in vivo and ex vivo helical computed tomography (HCT) and ex vivo μCT. The mineral matter in the sialoliths consisted essentially of apatite (89 vol%) and whitlockite (11 vol%) with average density of 1.8 g/cm3. In hydrated conditions, the mineral mass prevailed with 53 ± 13 wt%, whereas the organic matter, with a density of 1.2 g/cm3, occupied 65 ± 10% of the sialoliths’ volume. A quantitative relation between sialoliths mineral density and X-ray attenuation is proposed for both HCT and μCT.

Salivary stone or sialoliths are most common disease of salivary gland. Submandibular gland and its duct constitute 80-95 % of the salivary stone, about 5-20% occur in the parotid gland and only 1-2% in the sublingual gland and the rest seen in the minor salivary gland [1]. The submandibular stone is most frequently involved because of its anatomic location, long tortuous duct with a narrow orifice compared to the main portion of the duct [2]. Submandibular stones constitutes 82% inorganic and 18% organic material whereas parotid stone 49 % inorganic and 51% organic material [3].

Objectives. To evaluate the incidence and nature of complications associated with diagnostic and interventional sialendoscopies and to report intervention failures in a prospective setup. Study Design. Prospective observational study. Setting. Academic tertiary care university hospital. Subjects and Methods. Patients who underwent diagnostic or interventional sialendoscopy between October 2015 and December 2016 were prospectively enrolled. Patient data, operation-related factors, treatment failures, and complications were recorded into a database and analyzed. Results. A total of 140 sialendoscopies were attempted or performed on 118 patients; 67 (48%) were for a parotid gland and 73 (52%) for a submandibular gland. The sialendoscopy was interventional in 81 cases (58%), diagnostic in 56 (40%), and not possible to perform in 3 (2.1%). A total of 21 complications were registered for 21 sialendoscopies (15%) and 21 patients (18%). The most common complication was infection, in 9 cases (6.4%). Other observed complications were salivary duct perforation (4 cases), prolonged glandular swelling (3 cases), transient lingual nerve analgesia (2 cases), basket entrapment (2 cases), and transient weakness in the marginal branch of the facial nerve (1 case). All complications were related to interventional procedures or papilla dilatation. Failure to treat occurred in 21 (15%) sialendoscopies: sialendoscopy itself was unsuccessful in 3 cases, and an intended intervention failed in 18 cases. Conclusion. Complications in sialendoscopy are usually related to interventional procedures. The complications are mainly minor and temporary but lead to additional follow-up visits, further treatments, and sometimes hospitalization. Sialendoscopic procedures are safe but not free of complications.

Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.

Introduction and importance Majority of salivary gland stones (sialoliths) occur in the submandibular gland (Wharton's duct and parenchyma) accounting for 80% of cases. A Giant calculus of more than 3 cm is a rare encounter. Case presentation We present a 45-year old male patient who undergone surgical removal of a giant submandibular gland calculus which was reported by the patient as a result of a hard mass beneath the tongue with occasional pain being experienced during intake of meals. Clinical discussion Clinical assessment revealed a painless palpable hard mass beneath the tongue though with some dull pain being experienced during intake of meals. Local examination showed a hard mass at the sublingual region but not adhered to surrounding structures. The overlying intraoral mucosa appeared normal and not inflamed and with neither enlarged ipsilateral submandibular gland nor cervical lymph nodes. The patient was then prepared for surgical removal of the calculus under general anesthesia where a single giant calculus (measuring 4 cm) was extracted by marsupialization of Wharton's duct. Conclusion A giant calculus of more than 3 cm is a rare encounter and they remain to be one of the causes of submandibular gland dysfunction., Highlights • Most of the salivary gland sialoliths (80%) involve the submandibular gland • A Giant calculus of more than 3 cm is rare • Flow of saliva against gravity, high calcium and mucin content and its more alkaline pH explains calculi formation. • Patients normally present with pain either before or during intake of meals and may have a history of recurrent swelling of the involved gland • Intraoral extraction of a calculus should be advocated aiming at gland preservation

Pathologic calcification of soft tissues occurs when calcium salts, essentially calcium phosphate, are deposited in an unorganized fashion in soft tissue (heterotopic calcification). There are three types of heterotopic calcification: 1) Dystrophic calcification which occurs in degenerating, inflamed, and necrotic tissues. 2) Metastatic calcification results when calcium salts are precipitated in normal tissue as a result of abnormal high levels of blood calcium or phosphate. 3) Idiopathic calcification (calcinosis) occurs in normal tissue despite normal blood calcium level.

INTRODUCTION: Sialoliths (salivary gland stones) are calcified obstructions that occur in the salivary gland or duct. Sialolith is the most common disease of the salivary glands. Majority of the sialoliths occur in the submandibular gland and can be observed at almost any age. For the diagnosis of sialolith, conventional radiography, ultrasonography and computed-tomography can be used together with clinical examination. CASE REPORT: In the first case, radiopacities were seen under the right mandibular corpus and in the left mandibular angulus region on panoramic radiographs of a 66-year-old female patient. Ultrasonographic evaluation showed these radiopacities to be sialoliths. The patient had no other symptom and was, therefore, followed periodically. The second case was a 61-year-old male patient; in the intraoral examination, hard masses were detected in the left submandibular gland region and no salivary flow was observed in the left Wharton duct. Radiopacities were seen on panoramic and mandibular occlusal radiographs. On ultrasonography, these appeared to be sialoliths and were removed intraorally by excision. The third case was a 55-year-old female patient applied to our clinic with pain on the right cheek and ear while eating. In the intraoral examination, inflammation was detected in the right Stenon duct. On ultrasonography, sialolith and infected parotid gland with heterogeneous echogenicity were noticed. The sialolith was removed surgically under general anesthesia. CONCLUSION: Application of appropriate imaging techniques is important for the diagnosis of sialolith. The diagnosis and treatment of sialolith requires multidisciplinary clinical approach.

Sialoliths are calcified structures that develop into the salivary duct system, they have a round or oval shape and are usually asymptomatic. They result from the deposition of calcium salts around focal areas of organic matter and grow continuously, with the possibility of causing obstruction and reduced salivary flow. Commonly reported in humans, sialoliths may also affect, less frequently, the salivary glands of domestic and wild animals. This paper aimed to describe the histopathological characteristics of a sialolith affecting the excretory duct in the salivary gland of an adult male specimen of the tropical bat Artibeus lituratus (Chiroptera: Phyllostomidae). This specimen was collected in the urban area of Vitória de Santo Antão, Pernambuco, Brazil. Histological preparations were stained with hematoxylin and eosin (HE) and histochemical techniques with Schiff-periodic acid (PAS) and Alcian blue (pH 1.0 and 2.5) were applied for a better characterization and description of the sialolith. Although the formation of sialoliths is very common in the salivary glands of mammals, its occurrence in bats had not been reported before. Sialólitos são estruturas calcificadas que se desenvolvem dentro do sistema ductal salivar, apresentando formato redondo ou oval e, geralmente, são assintomáticos. Resultam da deposição de sais de cálcio ao redor de áreas focais de matéria orgânica e crescem continuamente, podendo provocar obstrução e redução do fluxo salivar. Comumente relatada em humanos, os sialólitos também podem, em menor frequência, acometer glândulas salivares de animais domésticos e silvestres. O trabalho objetivou descrever as características histopatológicas de um sialólito acometendo o ducto excretor de glândula salivar de um espécime adulto, macho, do morcego tropical Artibeus lituratus (Chiroptera: Phyllostomidae). Esse espécime foi coletado na área urbana de Vitória de Santo Antão (PE). Preparados histológicos foram corados com hematoxilina e eosina (HE) e técnicas histoquímicas com ácido periódico de Schiff (PAS) e azul de Alcian (pH 1,0 e 2,5) foram aplicadas para melhor caracterização e descrição do sialólito. Embora a formação de sialólitos seja muito comum em glândulas salivares de mamíferos, sua ocorrência em morcegos ainda não havia sido relatada.

Sialolithiasis is a common disease of the major salivary glands, characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions. Sialoliths usually measure from 1 mm to 15 mm have been reported in the literature. The submandibular gland and its duct appear to be the most susceptible sites for this disease. In this article, we report two unique cases, including a giant bilateral case, measuring 50 mm in length and 5 mm in width on the right side and one, 30 mm in length, and 5 mm in width on the left side; and another case, measuring 83 mm in length. The diagnostic and therapeutic approaches consisted of transocclusal radiography with the conservative transoral surgical technique in both cases. The follow-up showed the normal function of the relevant salivary glands. To the best of our knowledge and belief, similar cases have not been reported in the literature.